성인에서의 베타글루칸의 혈당조절 효과: 메타분석
Beta-glucan for Glycemic Control Effects in Adults: a Meta-analysis
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연구배경: 섬유질 섭취를 늘리면 당 흡수가 지연되어 인슐린 농도가 낮아진다. 기존 연구 결과에선 식이섬유의 일종인 베타글루칸의 혈당조절에 대한 효과는 일정하지 않았다. 본 연구의 목적은 성인에 있어서 베타글루칸의 혈당조절에 대한 효과를 평가하는 것이며 이를 위해 메타분석을 시행하였다. 방법: 문헌검색은 전자검색(Cochrane, PubMed, EMBase)과 전수 및 참조문헌검색을 실시하였다. 검색을 위해 사용한 용어는 beta-glucans [mh], "Avena sativa" [mh], "Hordeum" [mh], beta glucan* [tw], oat [tw], barley [tw]등 이었고, 언어에 제한을 두지 않았다. 혈당조절을 다루는 무작위 임상 대조 연구만을 대상으로 했으며, 베타글루칸의 양을 명기, 혹은 계산 가능한 연구, 당 조절에 대해 임상적으로 관련이 있는 하나 이상의 임상 결과를 표시한 연구, run-in period는 2주 이상, 실험 기간은 2주 이상인 경우의 연구를 포함시켰다. 메타분석을 위해 먼저 효과의 크기에 대한 이질성을 여부를 검정 후 고정효과 모델을 사용하였다. 결과: 조사 결과 43개의 연구가 선정되어 전문을 조사하였으며, 이중 4개의 연구가 포함기준을 만족하여 분석에 포함되었다. 배제된 연구의 주원인은 베타글루칸의 양을 알 수 없는 경우가 가장 많았다. 통합결과, 공복혈당의 효과의 크기는 0.13 (95%CI: −1.25 to 1.51)이었고, 혈청 인슐린치의 효과의 크기는 −0.95 (95%CI, -2.37 to 0.47)이었다. 결론: 본 연구에서는 성인에 있어서 베타글루칸의 공복 혈당과 인슐린에 대한 영향은 대체로 부정적이었으나, 효과를 판단하기에는 근거가 불충분했다. 따라서 향후 충분한 검정력을 가지면서, 보완된 방법에 의한 무작위 임상 대조 연구가 필요하다.
Abstract
Background: Recently, there has been an increase of emerging concerns between dietary fiber and diabetics. Increasing intake of dietary fiber leads to delaying absorption of glucose, and lowering of serum insulin levels. In the past studies, there were inconsistent glycemic control effect of beta-glucan. Our purpose was to assess the glycemic control effect of beta-glucan in adults. Methods: Electronic searches (Cochrane, PubMed, EMBase), hand-searching and review of reference were done. The search term for beta-glucans [mh], "Avena sativa" [mh], "Hordeum" [mh], beta glucan* [tw], oat [tw], barley [tw], with no language restriction were used. All RCT that included available data of beta-glucan or that could impute dose of beta-glucan, at least one relevant outcome of glycemic control, run-in period more than 2 weeks, and intervention period of more than 2 weeks or greater were selected. A fixed-effect model was used to assess the summary effect of studies. Results: A total of 43 articles were identified, 4 studies met our inclusion criteria and then analyzed. In pooled analysis, the effect size of fasting glucose level was 0.13 (95%CI: −1.25 to 1.51), and serum insulin level was −0.95 (95%CI, −2.37 to 0.47). It was impossible to adjust for sex and age owing to the lack of raw data. Conclusion: In this review, the results suggested that there were negative impacts of beta-glucan on fasting glucose and serum insulin level in adults, but we concluded that there was insufficient evidence to confirm about glycemic control effect. More powerful and well-designed RCT were required to confirm about glycemic control effect of beta-glucan.
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